The National Attorneys General Training & Research Institute
Substance Abuse Newsletter October 2018
The following is a compendium of news reports over the past month that may be of interest to our AG offices who are dealing with substance abuse issues. Neither the National Association of Attorneys General nor the National Attorneys General Training & Research Institute expresses a view as to the accuracy of news accounts, nor as to the position expounded by the authors of the hyperlinked articles.
Just a few clicks on a smartphone app will improve Oklahoma’s response to one of its most-pressing public health crises. First responders are learning how to track opioid overdoses real-time, thanks to an initiative by the Oklahoma Bureau of Narcotics and Dangerous Drugs. Four local law enforcement agencies in Choctaw County are among a growing group who recently received training to address Oklahoma’s opioid crisis. Garvin County Sheriff Larry Rhodes was among the law enforcement officials in the first three counties to use the ODMAP app. Since his county is so sparsely populated, it’s important to identify overdose patterns that might occur in bordering counties, he said. OBN announced that 10 compliance agents will travel the state to train first responders to use the ODMAP software. The agency is dedicating about $970,000 annually to the program to cover the cost of those officers’ salaries and benefits. The program allows a first responder to enter the person’s age and gender, the location and whether the overdose was fatal. It does not include personally identifying information and can’t be used to track people or to investigate cases. Using the real-time OD mapping software is one recommendation that resulted from Attorney General Mike Hunter’s Commission on Opioid Abuse.
The head of the National Institutes of Health stated that science can help the nation find newer and smarter ways out of an epidemic that resulted in more than 49,000 opioid overdose deaths last year. NIH Director Francis Collins told the USA TODAY Editorial Board that his agency will fund new, longer-lasting treatments for more than 2 million Americans addicted to opioids, and develop nonaddictive therapies for the estimated 25 million who suffer chronic pain. "We know this is a brain disease," Collins said. "Any idea that this is just willpower and you ought to be able to get over it is completely contrary to what we know on the basis of strongest medical evidence." Collins took a skeptical view of treatment programs that purport to get people sober within a month, citing their high rate of failure. His agency, the nation's top funder of medical research, received $500 million from Congress this year to direct toward the opioid epidemic. The money will support improvements in the treatment of opioid misuse and addiction and pain management, among other efforts. Collins said he wants to see longer-acting forms of drugs to treat people with opioid-use disorder. The existing options are buprenorphine, methadone and naltrexone.
The office of Arizona Attorney General Mark Brnovich will be training faith leaders from across Arizona on how to administer Narcan, a life-saving opioid overdose reversal medication. The training is part of a toolkit created by the Attorney General’s Office to help churches and places of worship better serve the needs of their parishioners who are battling opioid addiction. The training also includes prevention tips, identifying signs of addiction, and where to turn for help. Representatives from the Attorney General's Office will conduct a Narcan training course onsite and will distribute doses of the life-saving opioid reversal drug to attendees. To date, the Attorney General's Office has trained over 300 members of law enforcement on how to administer Narcan, including "train the trainer" classes, providing critical life-saving training for hundreds of members of law enforcement across the state.
Rural Americans say drug addiction and abuse are the most urgent health problems facing their local community, according to a new poll by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health. In the poll, 48 percent of people said opioid addiction has gotten worse in their community in the past five years.
The number of people dying from drug overdoses in the United States has begun to level off after reaching a record high last year, Health and Human Services Secretary Alex Azar stated. The record numbers were largely driven by the opioid epidemic, but efforts to help support treatment at the local and community level are making a difference, Azar said. “We are so far from the end of the epidemic, but we are perhaps, at the end of the beginning,” Azar said at a conference sponsored by the Milken Institute, according to prepared remarks. Azar cautioned that it’s too soon to declare victory, and that drug overdoses are not declining. Drug overdoses, rather, are increasing at a slower rate than they have previously.
Washington State, which legalized recreational pot in 2012, has long had rules barring products that are “especially appealing to children.” Even so, the board has received public complaints that some candies currently sold in the state’s pot shops could be enticing to kids, said spokesman Brian Smith in an email. When the board looked into the complaints, “they too had concerns,” Smith said. In response, the agency will now reevaluate all edible products and could strip approval from some candies already on store shelves. In a presentation posted online, the agency identified colorful gummy-style and hard candies as ripe for a regulatory crackdown. According to the presentation, “all production” of hard candies, tarts, fruit chews, colorful chocolates, jellies and “gummy type products should cease as they will not qualify.” Companies making such products can sell them until they run out or until April 3, whichever comes first, the presentation said. Edibles producers must resubmit their products to the agency by Jan. 1. Other products will be reviewed on a case-by-case basis. Drinks, baked goods and tinctures will continue to be allowed. Approval of chocolates, cookies, caramels and mints will depend on factors like frosting, sprinkles and whether they’re dipped in colorful coating.
Marijuana use may pose a greater risk to the developing brains of teenagers than alcohol consumption, according to a new study. The analysis, published in the American Journal of Psychiatry, found that cannabis had greater short and long-term consequences than alcohol on four key components of teens' memory. The finding greatly surprised researchers. "We initially suspected alcohol would have a bigger effect," Patricia Conrod, lead author and professor of psychiatry at the University of Montreal. Researchers looked at four cognitive functions: Problem solving, long-term memory, short-term memory manipulation and the ability to stop a habitual behavior when needed. Marijuana had "significant" negative effects on all four, while the study could not tie alcohol to negative effects, Conrod said. However, alcohol's effects may be greater as teens drink more later in life, Conrod said. Authors examined nearly 4,000 students in the Montreal region over four years, starting when the average participant was about 13 years old.
Canada is legalizing the adult use of marijuana on Oct. 17 and will be the second and largest country to do so. The federal government established the broad outline of the legalization law but left it up to provinces and territories to fill in some of the details — such as whether to allow home grows, to establish a legal purchase age of 18 or 19, and whether to sell through government-run pot shops or private outlets. Canada's Cannabis Act allows people 18 and older to buy marijuana online or in retail stores. Most provinces have raised the minimum age to 19, however, to align with the drinking age. In the U.S., states with recreational legalization have an age limit of 21, which matches the drinking age. Canadian law sets a 30-gram limit on how much people can buy at once or possess in public. That's just over an ounce, which is the possession limit in all but one of the U.S. states with legal pot — Maine's limit is 2.5 ounces (71 grams). However, there's no limit on how much Canadians can possess in their homes. The Canadian law also allows for residents to grow up to four plants at home, though two provinces — Quebec and Manitoba — opted to forbid home-growing. U.S. states including California, Nevada, Alaska and Colorado allow home-growing of up to six plants.
The Department of Justice and Drug Enforcement Administration announced that Epidiolex, the newly approved medication by the Food & Drug Administration, is being placed in schedule V of the Controlled Substances Act, the least restrictive schedule of the CSA. In June 2018, the FDA announced it approved Epidiolex for the treatment of seizures associated with two rare and severe forms of epilepsy, Lennox-Gastaut syndrome and Dravet syndrome, in patients two years of age and older. Epidiolex contains cannabidiol (CBD), a chemical constituent of the cannabis plant (commonly referred to as marijuana). The CBD in Epidiolex is extracted from the cannabis plant and is the first FDA-approved drug to contain a purified extract from the plant. “DEA will continue to support sound and scientific research that promotes legitimate therapeutic uses for FDA-approved constituent components of cannabis, consistent with federal law,” said Acting DEA Administrator Uttam Dhillon. “DEA is committed to continuing to work with our federal partners to seek ways to make the process for research more efficient and effective.”
Marijuana use by drivers, particularly those arrested and involved in crashes, including fatal ones, is an emerging safety issue. A new guide that examines the potential road safety ramifications of the drug’s use was released to assist states considering changing their laws. To date, nine states have legalized recreational marijuana, and similar legislation has been proposed in at least 20 others, according to the Governors Highway Safety Association (GHSA), which issued “Traffic Safety Impacts of Marijuana Legalization”. The nonprofit organization representing state highway offices called the resource a “succinct compendium of research” that summarized the most pertinent driving studies to date; it also includes drivers’ views on marijuana and driving.
Joanne Thomka is the Editor of Substance Abuse News and may be reached at 202-326-6269. Substance Abuse News is a publication of the National Association of Attorneys General. Any use and/or copies of this newsletter in whole or part must include the customary bibliographic citation. NAAG retains copyright and all other intellectual property rights in the material presented in this publication. For content submissions or to contact the editor directly, please e-mail firstname.lastname@example.org.